#61: Vasculitis and Giant-Cell Arteritis: ‘Rheum’ for improvement
Published October 9, 2017
54 min
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    Keep your cool in the face of inflammation, and make the path to vasculitis diagnosis less tortuous with Dr. Rebecca Sharim, Rheumatologist and Assistant Professor of Medicine at Temple University. In this episode, we go with the flow from large vessel to small vessel vasculitides, and then learn how to make the diagnosis and management of Giant Cell Arteritis (GCA) and polymyalgia rheumatica (PMR) less of a headache. Correspondent, Dr. Bryan Brown cohosts! 

    Special thanks to Dr. Bryan Brown for writing our show notes, and creating figures for our handouts.

    Full show notes available at http://thecurbsiders.com/podcast

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    Case from Kashlak Memorial:  A 75 year-old woman with a PMHx of hypertension presents to the ED with three days of worsening left sided headache, now with left sided vision loss during a Norwegian folk festival. On review of systems, she also endorses a week of soreness of her shoulders and hips. This has never happened to her before.

    Time Stamps

    00:00 Intro

    03:07 Picks of the week

    09:13 Getting to know our guest

    15:00 Clinical case of vasculitis

    15:59 Defining and classifying vasculitis

    20:55 Workup for suspected vasculitis

    23:17 How to explain GCA to a patient

    25:08 Typical symptoms of vasculitis

    28:00 Chewing gum test

    29:34 Interpreting ESR

    32:54 Basic exam and lab workup for vasculitis

    35:23 Headache and suspicion for GCA/temporal arteritis

    38:10 Is a temporal artery biopsy still mandatory?

    39:20 Polymyalgia rheumatica

    40:59 Steps to take when GCA/temporal arteritis suspected in clinic

    43:55 PCP prophylaxis with high dose steroids

    46:30 DMARDs and steroid sparing agents

    48:12 Imaging studies to aid in diagnosis of GCA

    50:50 Complications of long term steroid therapy

    52:31 Take home points

    53:26 Outro

    Tags: giant, cell, arteritis, gca, vasculitis, steroids, temporal, biopsy, artery, esr, pmr, polymyalgia, rheumatica, vessel, headache, assistant, care, education, doctor, family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, meded, medical, medicine, practitioner, professional, primary, physician, resident, student

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